Provider Demographics
NPI:1184044489
Name:STANLEY, ANNE (MAOM, LAC, DIP OM)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:STANLEY
Suffix:
Gender:F
Credentials:MAOM, LAC, DIP OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4635 OUACHITA ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-3529
Mailing Address - Country:US
Mailing Address - Phone:713-261-2664
Mailing Address - Fax:
Practice Address - Street 1:427 W 20TH ST
Practice Address - Street 2:STE 710
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2441
Practice Address - Country:US
Practice Address - Phone:713-261-2664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01431171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist